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急性下肢深静脉血栓形成单纯抗凝与导管定向溶栓联合抗凝治疗效果的比较

Comparison of Treatment Result Between Anticoagulation Alone and Catheter-Directed Thrombolysis Plus Anticoagulation in Acute Lower Extremity Deep Vein Thrombosis.

作者信息

Choi Young Jin, Kim Dong Hyun, Kim Dong Il, Kim Hyun-Yul, Lee Sang Su, Jung Hyuk Jae

机构信息

Endovascular and Vascular Division, Department of Surgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.

出版信息

Vasc Specialist Int. 2019 Mar;35(1):28-33. doi: 10.5758/vsi.2019.35.1.28.

Abstract

PURPOSE

Deep vein thrombosis (DVT) is the third most common cause of cardiovascular morbidity and mortality. Anticoagulation has been the primary treatment modality for acute DVT. However, catheter-directed thrombolysis (CDT) has recently become widely accepted as an additional therapy to anticoagulation. We assessed comparative outcomes in patients with acute DVT who underwent anticoagulation therapy alone (ACA) group and those treated with CDT group.

MATERIALS AND METHODS

We retrospectively reviewed medical records of 149 patients with DVT from January 2011 to December 2015. We compared patients who received ACA group (n=120) and those who received CDT plus anticoagulation (CDT group, n=29). We analyzed the prevalence of lesions, thrombus removal rate in each lesion, and recurrence-free rate between the two groups.

RESULTS

We found thrombus involvement in a total of 281 lesions in the ACA group and 85 lesions in the CDT group. For the distribution of lesions in each group, those in the femoral vein accounted for 34.2% of all lesions and those in the popliteal vein accounted for 31.7%. During follow-up, the overall thrombus removal rate was 91.1% in the ACA group and 87.0% in the CDT group (P=0.273). The recurrence-free rate was higher in the CDT group in a log-rank test; however, there was no statistically significant difference between the two groups (P=0.594).

CONCLUSION

According to our results, there was no significant difference in thrombus removal and recurrence-free rates between the CDT and ACA groups. ACA still has an important role in the treatment of DVT.

摘要

目的

深静脉血栓形成(DVT)是心血管疾病发病和死亡的第三大常见原因。抗凝一直是急性DVT的主要治疗方式。然而,导管直接溶栓(CDT)最近已被广泛接受为抗凝治疗的辅助疗法。我们评估了单纯接受抗凝治疗(ACA)组和接受CDT治疗组的急性DVT患者的对比结果。

材料与方法

我们回顾性分析了2011年1月至2015年12月期间149例DVT患者的病历。我们比较了接受ACA治疗的患者(n = 120)和接受CDT联合抗凝治疗的患者(CDT组,n = 29)。我们分析了病变的发生率、每个病变的血栓清除率以及两组之间的无复发率。

结果

我们发现ACA组共有281个病变存在血栓,CDT组有85个病变存在血栓。对于每组病变的分布,股静脉病变占所有病变的34.2%,腘静脉病变占31.7%。在随访期间,ACA组的总体血栓清除率为91.1%,CDT组为87.0%(P = 0.273)。对数秩检验显示CDT组的无复发率更高;然而,两组之间没有统计学上的显著差异(P = 0.594)。

结论

根据我们的结果,CDT组和ACA组在血栓清除率和无复发率方面没有显著差异。ACA在DVT治疗中仍然具有重要作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f174/6453597/24effccf33ed/vsi-35-028f1.jpg

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